Basic Information
| Provider Information | |||||||||
| NPI: | 1972533644 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARGUELLES | ||||||||
| FirstName: | REYNALDO | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 245 CAMERON DR | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333263515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546083341 | ||||||||
| FaxNumber: | 9543060366 | ||||||||
| Practice Location | |||||||||
| Address1: | 9750 NW 33RD ST | ||||||||
| Address2: | 214 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330654042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543186594 | ||||||||
| FaxNumber: | 9543186604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 05/03/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ARNP1141592 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | ARNP1141592 | 01 | FL | ARNP | OTHER |